Preeklamptik gebe kadınlarda intratekal olarak uygulanan levobupivakain ve bupivakainin etkinliğinin karşılaştırılması
Yükleniyor...
Tarih
2011
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
Attribution-NonCommercial 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada, spinal anestezi ile sezaryen ameliyatı olacak preeklamptik gebelerde, levobupivakain ve bupivakainin etkinlik ve yan etki bakımından karşılaştırılması amaçlanmıştır.
Gereç ve yöntem: Prospektif randomize olarak planlanan bu çalışmaya; Preeklampsi tanısı almış ve spinal anestezi ile sezaryen ameliyatı olacak 18-45 yaş arası hastalar alındı. Hastalar rastgele iki gruba ayrıldılar; Grup B’ye 2 mL % 0.5 bupivakain (10 mg), Grup L’ ye ise 2 mL % 0.5 levobupivakain (10 mg) intratekal olarak uygulandı. Hastaların noninvaziv kan basınçları ve kalp atım hızları, spinal anestezi öncesi, işlem sonrası 3, 6, 9, 12, 15. dakikalarda ve sonrasında ise her 5 dakikada bir olacak şekilde operasyon sonuna kadar ölçülerek kaydedildi. Değerlendirmeler, gruplar arası hasta ve cerrah memnuniyetinin karşılaştırılması ile yapıldı. Puanlamada vizüel analog skor (VAS) kullanıldı. Bulgular: Spinal anestezi sonrası gruplar arasında 3, 15, 35 ve 40. dakikalardaki ortalama sistolik arter basınç
değerleri Grup B’de istatistiksel olarak anlamlı düşük bulunurken (p<0.05), kalp atım hızları açısından anlamlı bir farklılık saptanmadı. Grup B’de daha sıklıkla hipotansiyon gelişirken (15 hastaya karşın 10 hasta), oluşan hipotansiyonu düzeltmek için de istatistiksel olarak anlamlı miktarda daha fazla efedrin gerekti (p= 0.012). Hasta memnuniyeti Grup L lehine anlamlı olarak yüksek bulunurken (p=0.011), cerrahi memnuniyet açısından gruplar arasında fark bulunmadı (p>0.05). Sonuç: Preeklamptik gebelerde spinal anestezi uygulamalarında kullanılan her iki lokal anesteziğin de yeterince kaliteli cerrahi anestezi sağlamakla birlikte, levobupivakainin daha stabil bir hemodinami oluşturduğu saptandı.
Objectives: The aim of this study was to compare the efficacy and side effects of levobupivacaine and bupivacaine in pre-eclamptic patients that will undergo caesarean section by spinal anesthesia. Materials and methods: Preeclamptic, 18-45 years-old patients that will undergo a caesarean section were included in the study in a prospective randomized manner. They were separated into two groups: Group B, intrathecally received 2 mL 0.5% bupivacaine (10 mg), while Group L intrathecally received 2 mL 0.5% levobupivacaine (10 mg). Blood pressure and heart rates of the patients were measured and recorded at 3, 6, 9, 12, 15th minutes and thereafter, every 5 minutes during operation. The evaluations were done through the comparison of patient’s and surgeon’s satisfaction between the groups. Visual analog score (VAS) was used for comparison. Results: Systolic arterial pressure values at 3, 15, 35 and 40th minutes in Group B were significantly lower than those in Group R (p<0.05), no significant difference was found in heart rates. Group B more frequently developed hypotension (10 patients versus 15 patients), so significantly greater amount efedrin was needed to treat hypotension (p=0.012). Patient satisfaction was recorded high in favor of Group L (p=0.011), however no difference was found in surgeon satisfaction between two groups (p>0.05). Conclusion: Intrathecal levobupivacaine for spinal anesthesia ensured a more stable hemodynamics but both local anesthesia enabled a sufficient and adequate surgical anesthesia in pre-eclamptic patients.
Objectives: The aim of this study was to compare the efficacy and side effects of levobupivacaine and bupivacaine in pre-eclamptic patients that will undergo caesarean section by spinal anesthesia. Materials and methods: Preeclamptic, 18-45 years-old patients that will undergo a caesarean section were included in the study in a prospective randomized manner. They were separated into two groups: Group B, intrathecally received 2 mL 0.5% bupivacaine (10 mg), while Group L intrathecally received 2 mL 0.5% levobupivacaine (10 mg). Blood pressure and heart rates of the patients were measured and recorded at 3, 6, 9, 12, 15th minutes and thereafter, every 5 minutes during operation. The evaluations were done through the comparison of patient’s and surgeon’s satisfaction between the groups. Visual analog score (VAS) was used for comparison. Results: Systolic arterial pressure values at 3, 15, 35 and 40th minutes in Group B were significantly lower than those in Group R (p<0.05), no significant difference was found in heart rates. Group B more frequently developed hypotension (10 patients versus 15 patients), so significantly greater amount efedrin was needed to treat hypotension (p=0.012). Patient satisfaction was recorded high in favor of Group L (p=0.011), however no difference was found in surgeon satisfaction between two groups (p>0.05). Conclusion: Intrathecal levobupivacaine for spinal anesthesia ensured a more stable hemodynamics but both local anesthesia enabled a sufficient and adequate surgical anesthesia in pre-eclamptic patients.
Açıklama
Anahtar Kelimeler
Preeklampsi, Spinal anestezi, Bupivakain, Levobupivakain, Pre-eclampsia, Spinal anesthesia, Bupivacaine, Levobupivacaine
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
38
Sayı
1
Künye
Bali, N., Karaman, H., Tüfek, A., Kavak, G.Ö., Yıldırım, Z.B. ve Cengiz, M. (2011). Preeklamptik gebe kadınlarda intratekal olarak uygulanan levobupivakain ve bupivakainin etkinliğinin karşılaştırılması. Dicle Tıp Dergisi, 38(1), 19-25.
